Chiasmal and/or optic nerve apoplexy due to rupture of vascular malformation--case report--.
An 8-year-old boy presented with a rare case of optic nerve apoplexy caused by an arteriovenous malformation (AVM) manifesting as severe headache and blurred vision. Computed tomography (CT) showed a hyperdense suprasellar mass. Magnetic resonance (MR) imaging indicated a hematoma in the right optic nerve. MR angiography showed normal vessels. Right fronto-temporal craniotomy identified an aggregate of abnormal, nidus-like vessels adhering to the medial surface of the swollen right optic nerve and a drainer-like ectatic red vein. The diagnosis was probable AVM. To avoid optic nerve damage, the malformation was left intact. Two years later, the boy was readmitted with headache. CT showed bleeding, and angiography revealed feeder arteries and nidus in the suprasellar lesion. The diagnosis was optic nerve apoplexy due to AVM. His symptoms improved without intervention within days. He has not experienced any recurrence of the bleeding for 2 years.
Sasagawa
Yasuo
Y
Department of Neurosurgery, Kanazawa Medical University, Ishikawa, Japan. yacchan1218@yahoo.co.jp
Akai
Takuya
T
Sasaki
Takashi
T
Iizuka
Hideaki
H
D020771:Anterior Cerebral Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D002550:Cerebral Veins / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009880:Ophthalmic Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D009897:Optic Chiasm / Q000098:blood supply / Q000473:pathology; D009900:Optic Nerve / Q000098:blood supply* / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D015354:Vision, Low / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology